Medicine and Health Sciences Commons^™

Hyperostosis Frontalis Interna: Irregular Skull Ossification In Cadaveric Dissection, Anthony Sciuva, Sara Eliseo, Zhi Quan Kuat, Yeva Nayflish, Leslie Pryor Mcintosh

Research Day

Hyperostosis Frontalis Interna (HFI) is an unusual condition characterized by the thickening of the frontal bone of the skull. HFI has been found most often in post-menopausal women, with incidence rates surpassing men by nearly nine times. This abnormal thickening of the skull may compress the cerebrum leading to atrophy, frequent headaches, and cognitive impairment. In this case report, we describe an 88-year-old Caucasian female cadaver that originated with the Body Donor Program of PCOM Georgia with an extensive presentation of HFI. A distinct irregular ossification of the internal surface of the frontal bone was noted bilaterally with visibly demarcated …

Special Considerations In Facial Transplantation: A Systematic Review, Melanie Shpigel, Sammy Othman, Jason Cohn, Christopher Hill, Paige Bundrick, Gabriel F. Santiago, Chad Gordon

Research Day

Background: Vascularized composite allotransplantation (VCA) of the face is an exceedingly complex procedure, requiring extensive planning and surgical precision in order to successfully manage patients with facial disfigurements. This review aims to present an overview of the salient anatomic considerations in facial transplantation, as well as give attention to unique patient populations and special considerations.

Methods: A literature review was performed in search of articles pertaining to considerations in facial transplantation using the databases PubMed, Web of Science, and Cochrane. Articles selected for further review included full-text articles with an emphasis on specific anatomic defects and how they were addressed …

A Rare Anatomical Variation Of The Origin And Insertion Of The Extensor Pollicis Et Indicis Communis Muscle, Derek George, Travis Tuck, Samuel P. Prhalow, Cody Hyatt, Leslie Pryor Mcintosh

Research Day

The extensor compartment of the forearm is a site with frequent anatomic variation that are encountered during examination with radiologic imaging, surgery, and general cadaver dissections. One such variation is the extensor pollicis et indicis communis (EPIC) which has a prevalence of 0.5 to 4% in the global population. Our group at PCOM South Georgia discovered this anatomical variation on a female cadaver of 58 years during a routine dissection of 12 cadavers obtained through the Body Donor Program at PCOM Georgia. The EPIC muscle was encountered unilaterally on the posterior aspect of the right forearm between the extensor pollicis …

Effects Of Lycopene And The Mediterranean Diet On Prostate Cancer: A Critical Analysis Of The Data, Natalie Silk, Dianzheng Zhang

Research Day

Background: Prostate cancer (PCa) is one of the most widespread cancers diagnosed in men in the United States and is the second leading cause of cancer-related deaths worldwide. PCa will be a major cancer-related burden both socially and economically in the near future. It has been shown that dietary intake of natural anti-inflammatory agents are capable of inhibiting cancer progression, but due to the nature of dietary studies it is difficult to accurately conclude that diet is capable of impacting chronic diseases and mortality.This systematic review aims to collect and evaluate literature focused on prostate cancer progression and the natural …

The Effect Of Cardiopulmonary Disease On Lymph Node Hyperplasia And Structural Deviations, Yuhyun Kang, Vikas Damineni, Rice Kelsey, Shelley Dicecco

Research Day

Introduction: According to the Centers for Disease Control and Prevention, cardiopulmonary disease is the leading cause of death in the United States. Therefore, the different pathologies of the heart and lungs are studied extensively in the medical community. Current research hints at the possible association between the lymphatic system's dysfunction and cardiopulmonary disease's pathological progression. However, the effect of cardiopulmonary disease on the lymph nodes is not well known. A better understanding of the possible pathological changes to the lymphatic system associated with cardiopulmonary disease could help guide medical interventions.

Objective: This study aims to investigate the effect of cardiopulmonary …

Etiology Of Svc Syndrome And Its Role In Determining Best Treatment Approach - A Case Report, Molly Casey, Sagar Desai, Vinnit Khanna, Rakesh Ahuja

Research Day

Introduction: Obstruction of the Super Vena Cava (SVC) can result in symptoms, such as facial plethora and swelling, and be due to a variety of underlying causes besides lung malignancies, the rates of which have changed over time; the underlying etiology is used to determine the best management strategy.

Objectives: This case report aims to discuss the role of etiology in determining the best initial treatment for SVC syndrome (SVCS) and outlines the unique management for a patient that represents the changing demographics of SVCS causes.

Case Presentation: A 73-year-old male with end-stage renal disease (ESRD) and metastatic carcinoma of …

A Quality Control Study: Outcome Of Efforts To Improve Communication In The Cardiac Catheterization Lab, Molly Casey, Andrew Doorey

Research Day

Introduction: Implementing closed-loop communication (readbacks) can limit potentially devastating mistakes by facilitating an efficient but effective way of confirming the medical staff heard the physician order correctly.

Objectives: The objective of this study was to assess the success of efforts to improve the rates of closed-loop communication in the Cardiac Catheterization Lab.

Methods: This was an observational study that occurred at one location. A third-party observer recorded the rate of closed-loop communication over four weeks in the summer of 2019. Responses by medical staff to physician medication, equipment, and other miscellaneous orders were categorized as complete, partial from partial, partial, …

Hidden Constipation Presenting As Diarrhea, Phi Tran, Ashley Bloom, Clay Bunting, Harsha Upadhya, Bhavin Dave

Research Day

Introduction: Diarrhea and constipation are two of the most common gastrointestinal symptoms presenting in both inpatient and outpatient settings. Diarrhea presents as loose, watery stool often with increased frequency while constipation often presents as hard stool, decreased frequency, and increased straining. In a subset of patients that suffer from constipation, liquid stool from more proximal colonic segments may bypass impacted feces and result in diarrhea, thus creating a confusing clinical picture and potentially misleading treatment plan. Objectives: Our objective is to redefine IBSD with a new subset of patients with IBSD who have hidden constipation. This study could help open …

The Potential Benefit Of Oral Simethicone In Improving Colonic Visualization And Polyp Detection In Routine Colonoscopy Screenings, Phi Tran, Loukya Kanakamedala, Bhavin Dave

Research Day

Introduction: Colon cancer is the second leading cause of cancer deaths in the United States among men and women. Many of these cancers can be prevented through regular colonoscopy screening. However, the bowel preps used prior to the screening procedure create a frothy or “bubbly” appearance within the colon. Physicians have tried to overcome this with the flushing of water or using simethicone in the water canister during the procedure, but they have provided minimal efficacy and simethicone damages the colonoscope. As a result, physicians have a difficult time viewing the colonic mucosa and thoroughly inspecting the colon for polyps. …

Reducing Readmission Rates By Improving Transitions Of Care For Stroke Patients In The Pre-Covid And Covid Eras, Evan Kolesnick, Elise Lambertson, Robin Dharia

Research Day

Introduction: Acute cerebrovascular disease ranks among the top causes of 30-day readmissions. Studies have shown that enhancing and streamlining transitions of care (TOC) for patients can improve readmission rates for many conditions. Our research explores the impact of in-person and telemedicine TOC stroke clinic on readmission rates at an urban comprehensive stroke center. Methods: Participants were identified by ICD-10 diagnoses corresponding with stroke or transient ischemic attack at Thomas Jefferson University Hospital (TJUH). Starting in January of 2019, an in-person TOC clinic visit with a vascular neurologist or nurse practitioner was automatically scheduled within 1-3 weeks for patients discharged to …

Quantitative Analysis Of Cadaveric Pelvic Lymph Nodes, Brandon Y. Boeur, Matthew P. Kayal, Jade Johnson, Yuhyun Kang, Kelsey Rice, Alicia Schmidt, Shelley Dicecco

Research Day

Introduction: Lymphedema commonly develops as a result of cancer treatments, including surgical removal of lymph nodes (LN). Research suggests there are 500-800 (LN) throughout the body. Deciding how many LN to remove and predicting possible severity of damage can become problematic when the range of LN in one area can vary by 30 LN.

Objective: The purpose of this study was to investigate more precise ranges of pelvic LN within cadaver samples.

Methods: Quantification of LN for number occurred on cadavers simultaneous with DO, PT, and PA students’ dissections. Demographics of the cadavers were 27 female, 16 male, 39 Caucasian, …

Predictive Factors And Outcomes In Patients With Severe Postoperative Anemia Following Total Joint Arthroplasty, Hunter Hayes, Yash Chaudhry, Sandesh Rao, Gregory Toci, Kevin Mekkawy, Julius Oni, Robert Sterling, Harpal Khanuja

Research Day

Background: Perioperative allogenic blood transfusions (ABT) have demonstrated associations with poor outcomes and increased complication rates following total joint arthroplasty (TJA). Recent strides in blood conservation methods have been made, including multimodal blood management, tranexamic acid (TXA) use, and restrictive transfusion strategies in order to reduce risk associated with transfusion. While the literature on transfusions and outcomes is extensive, the consequences of low postoperative hemoglobin is less well defined. This study aimed to identify factors and consequences associated with severe anemia (hemoglobin <8g/dL) following primary TJA.

Methods: A retrospective review was conducted of all the elective primary TJA at a single tertiary care medical …

Predictors Of Post-Deployment Distress In Female Veterans., Shalonda Griffin, Robert A. Ditomasso, Bradley Michael Rosenfield, Odelia Mcfadden

Research Day

Introduction: The female veteran population is expected to increase over the next few decades, representing approximately 16.3% of the living population by the year 2042. As women are discharged from the military, they are frequently challenged with the tasks of reintegrating into society and adjusting to life. While some women successfully readjust, many continue to struggle with combat-related challenges and reintegration stressors such as mental health, military sexual assault, substance abuse, interpersonal relationship issues, and everyday necessities. The purpose of the present study was twofold: (a) to identify factors associated with and predictive of postdeployment distress and (b) to identify …

Accidents/Injury Prevention, Amanda Gill, Kyle Kuzur

Health Fair: Tools & Lessons for K-12

No abstract provided.

Self-Esteem, Chanel Dixon, Rachel Bynum, Ashtyn Cottle

Health Fair: Tools & Lessons for K-12

No abstract provided.

Minimally Invasive Surgery For Septic Arthritis Of The First Metatarsophalangeal Joint: An Uncommon Approach Utilizing Small Joint Arthroscopy, Michael Thomas, Hinal Patel, Jeffrey Belancio

Rowan-Virtua Research Day

Small joint arthroscopy can be utilized for septic arthritis, synovitis, osteochondral lesions, arthritis, and various other pathologies. However, information regarding arthroscopy of the first metatarsophalangeal joint (MTPJ) is limited in the literature. This case report discusses the use of arthroscopy for septic arthritis of the 1st MTPJ.

Ring Based Wearable Bioelectrical Impedance Analyzer For Body Fat Estimation, Muhammad Usman, Adarsh Gupta, Wei Xue

Rowan-Virtua Research Day

Introduction

• Obesity is the most serious public health problem because it is linked to cardiovascular diseases.
• Measuring fat mass is necessary to study the obesity epidemic.
• Fat mass can be estimated by measuring impedance of the human body.

Conclusions

• A novel bioelectrical impedance analyzer for body fat estimation.
• Device validated for 40 healthy human subjects against commercial analyzer.
• Great potential to replace commercial analyzers for wearable real-time body fat monitoring.

Robotripping: The Dangers Of Abusing Dextromethorphan, Tiffany Sin, James Espinosa, Dana Fichter

Rowan-Virtua Research Day

Dextromethorphan (3-methoxy-N-methylmorphinan), also known as “DXM,” is a synthetically produced drug available in many over-the- counter (OTC) cough and cold medications as a centrally acting cough suppressant that binds to NMDA receptors. In a 2006 national survey of 50,000 students, 4, 5, and 7% of 8, 10, and 12th graders reported DXM abuse in the past year. In high doses, DXM can cause euphoria, hallucinations, dissociations, and distortion of cognition and perception. DXM abuse is also known as “Robotripping,” “Robodosing,” “Dexing,” “Tussin,” or “Triple Cs” because Robitussin® and Coricidin® Cough and Cold are most frequently abused. DXM has replaced codeine …

Posterior Reversible Encephalopathy Syndrome (Pres), Brittany Fera, Andrew Caravello

Rowan-Virtua Research Day

Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiographic syndrome that describes certain neuroimaging findings in association with clinical symptoms such as headache, seizure, encephalopathy and vision changes. Classically, PRES is associated with poorly controlled hypertension, and patients present with elevated blood pressure in addition to their symptoms. Most importantly, imaging findings and symptoms are typically reversible, and are a separate entity from ischemic or hemorrhagic cerebrovascular accidents or autoimmune causes of similar symptoms, such as multiple sclerosis.

Safety Of Silver Oxide Coated Biomaterials In Mice, Michael Klug, Darien L. Seidman, Rahyan Mahmoud, Destiny Morot, Lei Yu, Jeffrey D Hettinger, Renee M Demarest

Rowan-Virtua Research Day

It has been demonstrated that silver oxide coatings designed by our collaborators are able to prevent E. coli and P. aeruginosa attachment to biomaterials in vivo. These findings demonstrate that such coatings show promise in preventing the development of biofilm on biodevices. However, it is unknown if the use of silver oxide in this fashion is toxic in vivo. The goal of this project was to determine whether our silver oxide coatings are safe to use in vivo. To assess the toxicity of our silver oxide formula, mice were implanted with either silver oxide coated titanium discs or uncoated titanium …

Rheumatoid Nodule Mimicker Mycobacterium Haemophilum: A Case Presentation, Elisa Griswold

Rowan-Virtua Research Day

Mycobacterium haemophilum is a rare infection that can present in humans as subcutaneous nodules and cutaneous lesions. With a growing number of immunocompromised patients, M. haemophilum infections are becoming more common. Rheumatoid nodules in comparison are very common and can occur in approximately 25% of patients with Rheumatoid Arthritis (RA). Here we discuss a case in a patient with Rheumatoid Arthritis who developed subcutaneous nodules that mimicked rheumatoid nodules, but were later determined to be infectious nodules from Mycobacterium haemophilum.

The Prevalence Of Postpartum Depression In Black And Hispanic Women In New Jersey, Courtney Chineme, Rachel Shmuts, Chris Canlas

Rowan-Virtua Research Day

Postpartum depression (PPD) is defined as symptoms of major depressive disorder (MDD) within one month of giving birth with the prevalence in the United States being 10-15%. There are well documented instances of racial differences and their effects on maternal outcomes including infant, maternal mortality and postpartum mood disorders. In New Jersey, there are monitoring systems that explore the relationships between maternal characteristics such as race, age, education level, insurance status, and racial bias and how they may correlate with higher incidences of Postpartum Depression (PPD) in these communities of women. The purpose of this comparative study is to analyze …

Replication Protein A (Rpa) Targeting Of Uracil Dna Glycosylase (Ung2), Derek Chen, Brian P Weiser

Rowan-Virtua Research Day

Replication Protein A (RPA) is a single stranded DNA binding protein which stabilizes ssDNA for replication and repair. One function of RPA is to bind the DNA repair enzyme uracil DNA glycosylase (UNG2) and direct its activity towards ssDNA dsDNA junctions.

UNG2 removes uracil bases from DNA which can appear through dUMP misincorporation or through cytosine deamination. If uracil is present instead of a cytosine, then the original GC pair becomes a GU pair. The uracil will then base pair to adenine in the replicated daughter strand. This results in a GC → AT mutation that could contribute to cancer …

Seeking Sustainable Solutions To Period Poverty Amongst Homeless Women In Camden County, Nj, Bilal Khan, Alana Smith, Melisa Ibarra-Zavala

Rowan-Virtua Research Day

Health Careers Opportunity Program (HCOP) – National Ambassadors is an effort for underserved high school, undergraduate, and medical students to collaborate on a research-based community service project to equip future health professionals with tools to heal their communities.

The average woman spends up to 3500 days of their life menstruating. Menstrual health is therefore not just a fundamental human right, but a robust indicator of community well-being. Despite the biological inevitably of menstruation, barriers to practicing adequate menstrual hygiene, or “Period Poverty,” are far common and often ignored in public forums. Period products face a luxury goods sales tax in …

Syncope Or Seizure?, Joseph Heron, Kevin Dwyer

Rowan-Virtua Research Day

Syncope is a common complaint in the emergency departments, accounting for 1-2% of visits, and can approach admission rates of a staggering 85%. The causes and conditions can be numerous, ranging from benign to life threatening. A good background history can go a long way in determining the etiology of the patient’s syncope. We describe a case of an elderly male who presented with a reported chief complaint of seizures, another syncope-mimic seen in the emergency department. He had a history of CAD, HTN, AAA, and osteoarthritis but no prior history of cardiac arrhythmia, MI, or structural heart disease. The …

Spontaneous Splenic Laceration Presenting As Stable Angina In The Ed, Lea Rowson, James Baird

Rowan-Virtua Research Day

We present a case of a 62-year-old female who presented to the emergency department complaining of classic cardiac chest pain and was ultimately diagnosed with hemoperitoneum due to a splenic laceration sustained during recent colonoscopy. The signs and symptoms between these two diagnoses can be vaguely similar, and a missed diagnosis of either leads to increased morbidity and mortality. To make an appropriate diagnosis, a thorough history and physical examination is imperative. Observation of non-musculoskeletal left shoulder pain in addition to abdominal tenderness should lead the astute clinician down a different path towards diagnosis. Kehr’s sign is present in many …

Use Of Point Of Care Ultrasound In The Emergency Department For Diagnosis Of Femoral Pseudoaneurysm, Stephen Janssen, Jeffrey Gardecki, Giovanna Finocchio

Rowan-Virtua Research Day

Iatrogenic pseudoaneurysm after puncture or intervention of the femoral artery is a rare complication of arterial surgical intervention occurring in 0.05-0.50% of diagnostic and therapeutic catheterizations and can present weeks after initial presentation. Today we present a 57-year-old gentleman 3 months status post femoral artery stent who presented with swelling to his right groin. Point of care ultrasound was used to diagnose an actively bleeding pseudoaneurysm with hematoma that ultimately led to repeat stenting. This case shows how point of care ultrasound can expedite diagnosis and intervention and is a useful tool for the emergency physician at initial presentation.

The Role Of Primary Care Physicians In Post-Partum Depression (Ppd), Elizabeth Bowman

Rowan-Virtua Research Day

Background

• Symptoms of depression lasting longer than 2 weeks following birth
• 10-15% of new mothers affected yet 50% of cases go undiagnosed
• Long-lasting consequences for the mother, baby, and father
• Multi-factorial condition

Conclusion

• Primary care providers are the first-line defense against PPD
• Many providers are resistant to PPD screenings
• Interventions from primary care providers are effective

The Impact Of Exercise On Pregnant Women Aged 18-40 And Fetal Development, Jinisha Patwa

Rowan-Virtua Research Day

68% of those who performed minimum level exercise prior to pregnancy stopped completely during early pregnancy.

Women stop exercising during pregnancy due to worries about the impact it may have on the development of the fetus.

Starting moderate-intensity, weight-bearing exercise early in pregnancy increases placental growth rate and volume.

Exercise reduces the risks of excess gestational weight gain and high maternal body weight before pregnancy.

Physical exercise reduces the risk of gestational diabetes mellitus.

The Effect Of Carfilzomib And Bortezomib Based Regimes On Cardiotoxicity In Multiple Myeloma Patients At Cooper University Hospital, Ami Patel, Tulin Budak-Alpdogan, Stalam Tapati

Rowan-Virtua Research Day

Introduction

• Multiple myeloma (MM) is a cancer of plasma cells, which is a white blood cell that normally produces antibodies
• Treatment in patients younger than 65 years old is typically high dose chemotherapy, usually with bortezomib based regimens or lenalidomide dexamethasone, followed by a stem cell transplant
• For patients with relapsed myeloma, carfilzomib is usually the treatment of choice
• Carfilzomib is a highly selective, irreversible proteasome inhibitor that binds to the 20 S proteasome. Several studies have illustrated that carfilzomib has been associated with cardiovascular adverse events (CVAE).
• Current literature on the role and effect of bortezomib on cardiotoxicity is …